Some people may think I'm a pessimist, but my "pessimism" is just the defensive measure of someone who expects every new restaurant to be better than every other restaurant I've ever visited; every cup of coffee better than every cup of coffee I've drunk before; every twist in the Patient Protection and Affordable Care Act (PPACA) implementation story to be more exciting than the last.

I still trust that the people at the Federal Bureau of Investigation (FBI) and the National Security Agency (NSA) are working to keep bad guys from blowing me up when I pass through Herald Square on the way to the subway, not divulge the angry emails I dashed off in a fit of rage then, thank goodness, got myself to delete before hitting send.

I firmly believe that, whatever problems PPACA, the PPACA exchange program, the U.S. Department of Health and Human Services (HHS), and various HHS agencies and other federal agencies have, federal officials (and state officials, and employees of the state and federal PPACA exchange vendors) just want to make the exchanges a regulation-friendly version of Travelocity.

But it hit me, as I was trying to figure out how to cover the story about the tech company executives visiting the White House today, that the HHS HealthCare.gov enrollment system story is closely related to the NSA surveillance controversy story.

The White House apparently wanted the executives to come in and talk about how much better HealthCare.gov is working. Instead, it seems, the executives talked mainly (maybe solely) about how to get rid of the impression that their companies are funneling every character we type straight to the NSA.

On the one hand, the Clinton administration and the Bush administration liked talking points, but the Obama administration is so addicted to talking points that, a lot of the time, it doesn't even try to create supporting documents that at least look like real, grownup, fact-based documents. When HHS is trying to talk up the PPACA exchange program and HealthCare.gov, it just seems to glue a few tweets into a page-long document, and pretends that's a report.

On the other hand, the HHS media people probably have brilliant consultants with doctorates who can explain, in convincing detail, why that communication strategy is the best possible communication strategy.

But, on the third hand, if HHS is so obviously lacking in candor even about little details about HealthCare.gov -- what's up with actual paid enrollment, for example -- how can I trust it to be candid about big stuff, like how the PPACA risk management programs will be working?

If even House committees have to pry documents out of the HealthCare.gov vendors with a litigation crowbar, how can I trust the folks at the NSA to give little people like me the correct time of day, let alone trust the officials there to suppress the urge to look at me through my cell phone camera or to keep from scanning my computer when I'm on deadline and trying to bang out copy?

About the Author

Allison Bell, LifeHealthPro.com Health Insurance Channel Editor, has been covering health insurance long enough to own a copy of the HIPAA conference report. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School... More